[Radiotherapy of non-Hodgkin lymphoma-discussion of modern treatment concepts and innovations].

Radiologie (Heidelberg, Germany) Pub Date : 2025-07-01 DOI:10.1007/s00117-025-01477-3

Michael Oertel, Hans Theodor Eich

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Abstract

Background: Radiotherapy is an established treatment modality for malignant non-Hodgkin lymphoma. However, the complexity of the treatment situations demands precise treatment indication and execution. The following review presents modern radiooncological treatment strategies.

Materials and methods: A selective literature search addressing radiotherapy of malignant non-Hodgkin lymphoma was conducted, focusing on diffuse large B‑cell lymphoma, marginal zone lymphoma, and follicular lymphoma. Relevant studies as well as the German national S3 guidelines were identified and discussed.

Results: Indolent lymphoma in early stages can be treated with radiotherapy in curative intent. In carefully selected cases, dose de-escalation may be possible, although it is not recommended by the German S3 guideline. In the case of aggressive non-Hodgkin lymphoma, consolidation radiotherapy is conducted after systemic therapy, addressing regions with an increased risk of recurrence. Particularly patients with positron-emission tomography (PET)-positive residuals should be irradiated. Innovations like the application of radiotherapy before or after chimeric antigen receptor T‑cell therapy and the emerging implementation of online adaptive radiotherapy will enrich the therapeutic landscape in the future.

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【非霍奇金淋巴瘤的放疗——现代治疗理念与创新探讨】。

背景：放疗是恶性非霍奇金淋巴瘤的既定治疗方式。然而，治疗情况的复杂性需要精确的治疗指示和执行。以下综述介绍现代放射肿瘤学治疗策略。材料和方法：对恶性非霍奇金淋巴瘤的放疗进行了选择性文献检索，主要集中在弥漫性大B细胞淋巴瘤、边缘带淋巴瘤和滤泡性淋巴瘤。确定并讨论了相关研究以及德国国家S3指南。结果：早期无痛性淋巴瘤放疗治疗效果良好。在精心挑选的病例中，剂量递减是可能的，尽管德国S3指南不建议这样做。在侵袭性非霍奇金淋巴瘤的情况下，在全身治疗后进行巩固放疗，针对复发风险增加的区域。特别是有正电子发射断层扫描（PET）阳性残余的病人应该进行放射治疗。诸如在嵌合抗原受体T细胞治疗之前或之后应用放射治疗的创新以及在线适应性放射治疗的新兴实施将丰富未来的治疗前景。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Radiologie (Heidelberg, Germany)

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